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At least 613 records · Page 34Linked to original sources
PubMed1996

Asthma: an important disease to otolaryngologists--Part II: Asthma management strategy.

Asthma is a chronic inflammatory disease of the lower respiratory tract which is triggered by exposure to allergens or other airway irritants, and is commonly encountered in otolaryngologic practice. This three-part review is designed to assist otolaryngologists in effectively managing their asthmatic patients. In Part I, current information on the pathophysiology and increasing prevalence of asthma, its clinical variability, the assessment of asthma severity and methods for diagnosis of asthma were summarized. Part II discusses a tripartite strategy for asthma management, based on environmental controls, the use of anti-inflammatory therapies and patient education. In addition, pharmacologic treatments which are not primarily anti-inflammatory are reviewed in detail. The uses, effectiveness, side effects and suitability for drug combination therapy for mucolytic, anticholinergic, antihistamine, theophylline and beta agonist drugs are compared, and the disadvantages of beta antagonists are summarized. Part III concludes with an overview of anti-inflammatory therapies for asthma control.

Adrenergic beta-Agonists↗
PubMed1995

[Clinical significant correlation between to the onset of bronchial asthma in children and family history of allergic diseases. Part 1. Comparison of various allergic diseases in the family history and onset of bronchial asthma in children].

Two hundred and forty seven asthmatic and 246 non-asthmatic children were evaluated in order to find out the relationship between onset of asthma, family history of allergic diseases (FH) and environmental factors. The results are as it follows. Child with asthmatic symptoms shows high total serum IgE levels with/without FH. Asthma occurs significantly often with FH than without FH. There is no significant difference in onset of asthma between father and mother. Child has more asthma when either father or mother has asthma than allergic rhinitis. We concluded that family history of allergic diseases especially asthma is asthmogenic and environmental factors work as aggravating but not asthmogenic factors. The specific IgE is influenced by condition of the sensitization than family history of allergic diseases.

Asthma↗
PubMedDate not supplied

Rhinitis and asthma: nasal provocation test in the diagnosis of asthma.

Our purpose was to determine if the study of rhinitis is useful in the diagnosis of asthma. We formulated the hypothesis that the inflammation of the upper airway reflects the inflammation of the lower airway. It was found that there are allergens that produce rhinitis more frequently than asthma, and vice versa. This can be explained by size. This explanation, however, is questionable as the allergic proteins are extracted from the carrying agent, and through the lymphatic route or the blood, reach the entire human organism. It was also found that with bronchoalveolar lavage in allergic asthma it is possible to obtain the same results for eosinophils as with a nasal wash or using Citospyn. However, the results in the late phase are questionable. In the immediate phase and in the late phase, eosinophil cationic protein (ECP) was detected in the blood (in asthma) and in nasal washes (in rhinitis). In the immediate response tryptase was detected from the mast cells. The role of leukotrienes in asthma and rhinitis is well established in the early and late response. The use of leukotriene inhibitors guarantee their importance in the airway. Platelet-activating factor (PAF) has been demonstrated to increase vascular permeability and the use of antagonists were the best nasal feature. The inhalation of histamine caused bronchospasm, while instillation of histamine in the nasal passages increased resistance. With this information it seems that our hypothesis has been confirmed. Rhinitis and BHR together are equivalent to asthma, although the PFER decreases during the course of nasal provocation test (NPT) in nonasthmatic patients. In pure rhinitis patients, however, we find decreases in PFER due to effort. All this suggests that the study of nasal inflammation is still unclear with regard to bronchial inflammation.

Asthma↗
PubMed1998

Asthma and other atopic diseases in Australian children. Australian arm of the International Study of Asthma and Allergy in Childhood.

OBJECTIVE: To determine the prevalence of asthma, eczema and allergic rhinitis in Australian schoolchildren using the protocol of the International Study of Asthma and Allergy in Childhood (ISAAC). DESIGN: Questionnaire-based survey. SETTING: Melbourne, Sydney, Adelaide (in winter-spring, 1993) and Perth (in winter-spring, 1994). SUBJECTS: All children in school years 1 and 2 (ages 6-7 years) or in year 8 (ages 13-14 years), attending a random sample of 272 schools, stratified by age and city. MAIN OUTCOME MEASURES: Parent-reported (for 6-7 year olds) or self-reported (for 13-14 year olds) symptoms of atopic disease in the previous 12 months, or ever; treatment of asthma; and country of birth. RESULTS: 10,914 questionnaires were completed for 6-7 year olds and 12,280 for 13-14 year olds (84% and 94% response rates, respectively). Prevalence of wheeze in the past 12 months was 24.6% for the 6-7 year olds and 29.4% for the 13-14 year olds, and, among 6-7 year olds, was significantly higher in boys (27.4%) than girls (21.7%). Children born in Australia were more likely to report current wheeze than those born elsewhere (6-7 year olds: odds ratio [OR], 1.82; 95% confidence interval [CI] 1.55-2.15; and 13-14 year olds: OR, 1.88; 95% CI, 1.68-2.11). Prevalences of current eczema and allergic rhinitis were 10.9% and 12.0%, respectively, for the 6-7 year olds, and 9.7% and 19.6%, respectively, for the 13-14 year olds. Asthma, eczema and rhinitis coexisted in 1.8% of 6-7 year olds and 2.8% of 13-14 year olds. CONCLUSION: This study provides evidence that asthma prevalence in Australian schoolchildren is continuing to increase and is higher among Australian-born children than among those born elsewhere. Asthma, eczema and allergic rhinitis coexist to a lesser extent than expected. These results form the basis for future Australian and international comparisons.

Adolescent↗
PubMed1999

Executive summary of disease management of drug hypersensitivity: a practice parameter. Joint Task Force on Practice Parameters, the American Academy of Allergy, Asthma and Immunology, the American Academy of Allergy, Asthma and Immunology, and the Joint Council of Allergy, Asthma and Immunology.

Adverse drug reactions are a major health problem in the United States. About 25% of all adverse drug reactions have an allergic, pseudoallergic, or idiosyncratic/intolerant basis. Idiosyncratic drug reactions and drug intolerance are also included in this category. Drug allergy may be classified by the Gell and Coombs classification of human hypersensitivity (Type 1: IgE-mediated; Type 2: cytotoxic; Type 3: immune complex; and Type 4: cellular immune mediated). Drug allergy is also frequently characterized by the predominant tissue/organ involved (systemic, cutaneous, or visceral). To some extent, the structural characteristics of drugs and biologic products predict the type of hypersensitivity reaction.

Adverse Drug Reaction Reporting Systems↗
PubMed2004

Asthma Programme in Finland: high consensus between general practitioners and pulmonologists on the contents of an asthma referral letter.

AIMS: The purpose of the present study was to define quality criteria for an asthma referral letter using a national co-operative effort between general practitioners and pulmonologists. METHODS: A consensus-seeking expert panel representing primary and secondary health care merged evidence from the literature and existing national and local asthma programmes to produce 19 provisional criteria to be included in an asthma referral letter. These criteria were contained within a national questionnaire review which was sent out to groups of Finnish physicians. The target groups for the review were all chief pulmonologists in specialist care (n = 32), and representatives of all Finnish health centres (n = 283) - either the chief physician (n = 143) or the local asthma co-ordinating physician (n = 140). RESULTS: The overall response rate to the national questionnaire study was 75%. The three groups of responding physicians had very similar gradings on the necessity of the 19 provisional criteria, most of which were considered very necessary. 14 final disease-specific criteria for an asthma referral letter were derived as a result of this study. CONCLUSION: The main result of this study is an agreed data set of essential information that needs to be included in an asthma referral letter. Importantly these criteria were developed by general practitioners and pulmonologists together.

Journal Article↗
PubMed2001

Ethnic differences in asthma and associated phenotypes: collaborative study on the genetics of asthma.

BACKGROUND: In the Collaborative Study on the Genetics of Asthma, 314 families with 2584 subjects were characterized for asthma and allergy. OBJECTIVE: The purpose of this investigation was to examine clinical heterogeneity observed in asthma and allergic characteristics among 3 ethnic groups (African American, white, and Hispanic family members). METHODS: Pulmonary function parameters and asthma associated phenotypes were compared among the ethnic groups. RESULTS: In comparison with the other groups, African American sibling pairs had a significantly lower baseline FEV(1) percent of predicted (P =.0001) and a higher rate of skin test reactivity to cockroach allergen (P =.0001); Hispanic sibling pairs had significantly more skin reactivity overall (P =.001); and white sibling pairs had significantly lower total serum IgE (P <.05). In addition, there were significantly more relatives with asthma among the African American families than among the white and the Hispanic families (P =.001). CONCLUSION: Although different environmental backgrounds should be considered, these clinical differences could be due to differences in genetic susceptibility among the ethnic groups, such as those suggested by our previous genome screen.

Adolescent↗
PubMed2003

[Increasing prevalence of asthma in school children--ISAAC study (International Study of Asthma and Allergies in Children)].

UNLABELLED: The aim of the study was to assess changes in asthma prevalence between 1994/1995 (study I) and 2001/2002 (study II). Standardized ISAAC questionnaire was used. Randomly assigned population of school children 6-7 and 13-14 yrs of age was surveyed in Kraków and Poznań. RESULTS: The prevalence of wheezing ever increased significantly in group 6-7 yrs of age from 25.5% to 28.6% in Krakow and from 17.3% to 27.6% in Poznań, respectively in study I and study II. The similar rise was found in group 13-14 yrs of age in Krakow from 14.6% to 21.6%, in Poznań from 17.1% to 22.2%. In both age groups and in both centers the number of children with established asthma diagnosis increased: in group 6-7 yrs of age in Krakow from 4.0% to 5.8%, in Poznań from 1.3% to 5.9%; in group 13-14 yrs of age in Krakow from 2.3% to 6.8%, in Poznań from 2.0% to 5.2%. Analysis of current symptoms (in the last year) confirmed increasing prevalence of wheezing, wheezing after exercise and night cough in Poznań in both age group, in Krakow only in older children. In younger children in Kraków significant difference concerned only wheezing after exercise. The most frequent symptom reported by children was nocturnal cough in the last year. CONCLUSIONS: The prevalence of the asthma symptoms and established asthma diagnosis increased during last 7 years. However significant number of children presenting asthma symptoms remains still underdiagnosed.

Adolescent↗
PubMed1999

A genome-wide search for linkage to asthma. German Asthma Genetics Group.

Asthma is among the most frequent chronic diseases in childhood. Although numerous environmental risk factors have already been identified, the basis for familial occurrence of asthma remains unclear. Previous genome screens for atopy in British/Australian families and for asthma in different American populations showed inconsistent results. We report a sib pair study of a sample of 97 families, including 415 persons and 156 sib pairs. Following an extensive clinical evaluation, all participants were genotyped for 351 polymorphic dinucleotide markers. Linkage analysis for asthma identified four chromosomal regions that could to be linked to asthma: chromosome 2 (at marker D2S2298, P = 0.007), chromosome 6 (around D6S291, lowest P = 0.008), chromosome 9 (proximal to D9S1784, P = 0.007), and chromosome 12 (D12S351, P = 0.010). These linkage regions could be reproduced for all loci by analysis of total or specific immunoglobulin E (minimum P values at these regions were 0. 003, 0.001, 0.010, and 0.015, respectively).

Asthma↗
PubMed1999

Leukotrienes, leukotriene receptor antagonists and leukotriene synthesis inhibitors in asthma: an update. Part I: synthesis, receptors and role of leukotrienes in asthma.

Asthma is a chronic inflammatory disease associated with airflow obstruction. Airflow obstruction results from contraction of airway smooth muscle, mucosal oedema, increased secretion of mucus and infiltration of the airway wall by inflammatory cells, particularly eosinophils. Leukotrienes are thought to contribute to the pathophysiology of asthma. Leukotrienes are synthesised from arachidonic acid by a specific synthesis pathway whose key enzyme is 5-lipoxygenase. Cysteinyl leukotrienes (leukotrienes C4, D4 and E4) have been shown to mimic all the pathologic changes that are characteristic of asthma, whereas leukotriene B4 does not appear to exert biological properties relevant to asthma. Cysteinyl leukotrienes bind to two receptor subtypes: CysLT1 and CysLT2. Most of the biological properties of cysteinyl leukotrienes relevant to asthma are mediated through CysLT1 receptor stimulation.

Anti-Asthmatic Agents↗
PubMed1985

Asthma in infants and children--treatment of childhood asthma: Part II.

The various features of bronchial asthma as it pertains to infants and children are reviewed. Childhood asthma ranks among the most common causes of ill health and creates a myriad of physical and emotional problems for the child. Rarely, it may lead to death. Various anatomic and physiologic differences in children account for the increased risk to symptomatic airway obstruction and poor response to bronchodilators. Other features of childhood asthma that differ from adult asthma including the prognosis, differential diagnosis, and complications are discussed. The authors' views of the general principles, specific therapy, pharmacologic measures, and a self-management intervention program for the management of the pediatric patient with asthma are presented.

Adolescent↗
PubMed1987

Prevalence of abnormalities found by sinus x-rays in childhood asthma: lack of relation to severity of asthma.

We examined the prevalence of abnormalities found by sinus x-rays in patients with asthma. The overall prevalence of abnormalities found was greater in the patients with asthma, 43 of 138 (31.2%), compared to control patients with dental problems, 0 of 50 (p less than 0.001). However, the percent of patients with abnormalities found by sinus x-rays was the same whether the asthma was mild, requiring minimal medication, or severe, requiring multiple medications. The results provide no support for the hypothesis that sinusitis, as detected by abnormalities found by sinus x-rays, aggravates asthma and promotes increased need for medication to control the asthma.

Allergens↗
PubMed1988

Improvement in clinical asthma score and PaCO2 in children with severe asthma treated with continuously nebulized terbutaline.

We analyzed continuous nebulized terbutaline (CNT) therapy in 19 patients with 27 admissions for severe asthma and impending respiratory failure who failed to respond to our standard asthma protocol of methylprednisolone, aminophylline, and intermittently nebulized terbutaline. Terbutaline was administered by continuous face mask nebulization at a dose equaling the most frequent previous intermittent dose per hour (4 mg per hour). No patient with frank respiratory failure (i.e., PaCO2 greater than or equal to 60 torr, exhaustion, or coma) was studied. All patients improved, and therapy was stopped in a mean of 15.4 hours (range 3 to 37 hours). The average heart rate did not increase over baseline measurements through 24 hours of CNT. The mean clinical asthma score improved significantly during 8 hours, falling from 6.9 to 3.2 (p greater than 0.001). In 14 patients whose PaCO2 was greater than or equal to 39 torr (range 39 to 58 torr) and clinical asthma score was 6 or greater, PaCO2 decreased a mean of 11.7 torr during a mean of 8.1 hours. In six patients whose PaCO2 was 45 torr or greater at the start of CNT (mean 49, range 45 to 58 torr) and in whom we would have previously treated with intravenous isoproterenol, PaCO2 decreased a mean of 15 torr in an average of 8.7 hours. This preliminary study suggests that CNT is an effective therapy for severe asthma in children.

Administration, Inhalation↗